In surgical procedures, the steps involved in dissection, cauterization, suturing, etc. cause trauma to surrounding tissue and initiate the formation of local post surgical adhesions.
After surgical procedures such as anterior access spine surgery, general abdominal and pelvic surgery, cardiothoracic surgery, etc., a wound repair process begins in which scar tissue is laid down that disrupts the normal anatomic planes and results in soft tissue adhesions. These adhesions can cause post operative pain, bowel obstructions, and other complications. Further, upon revision surgery this scar tissue can cause a nearly blind navigation field and present challenges with mobilization of scarred down tissues (i.e., tissues that have adhered to nearby soft tissues, bone tissues or surgical implants). Vessel damage, nerve damage, and other soft tissue injury can be a hazard upon revision surgery.
After trauma surgery adhesions can form at the fracture site due to bone spurs or by attachments to the titanium or stainless steel plates or screws. These adhesions with surrounding tissues can cause post-operative complications such as tendon irritations, loss of tendon mobilization, and impaired local joint function. Further, these adhesions can cause challenges (and may result in surgical complications) during a subsequent hardware removal procedure.
In anterior access spine surgery, such as total disc arthroplasty, anterior lumbar interbody fusion and anterior plating, the soft tissue and blood vessels in front of the spine are mobilized during the access portion of the surgery. After the procedure, these vessels typically scar down (i.e., adhere) to the surgical site. These adhesions of the vessels increase the risk of vascular injury if a revision procedure needs to be performed. The incidence of vascular injury on revision surgical cases has been reported to be as high as fifty-seven percent (57%). A barrier device in these applications would serve two functions, first as a covering to protect the vessels from the hardware used in the spinal procedure and second as a guide and plane of dissection during the revision procedures to help remobilize the vessels.
In other spine applications a barrier can be useful as well. For example, in scoliosis treatment with growing rod procedures, it may be useful to prevent the growth of tissue onto the screws that will need to be accessed during the subsequent lengthening procedures. In cervical procedures a barrier could prevent adhesions from the esophagus to the spinal implants and surgical site in order to prevent complications such as dysphasia, irritations and erosion of the esophagus. In posterior spinal procedures, a barrier device can function as a dura repair or help to limit nerve root tethering post discectomy.
In cardiothoracic surgery, a barrier device can function to help facilitate re-operations for cardiac patients, by minimizing adhesion formations between the sternum and other tissues.
Similar challenges with adhesions have been described in general abdominal pelvic surgery as well as other surgical treatments.